Article: Volume 42 Number 8 Page 744 - October 2015

  Dent Update 2015; 42: 744-760  Read article

Oral surgery:  Pain Part 5a: Chronic (Neuropathic) Orofacial Pain

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Abstract: Neuropathic pain is a significant social and economic burden. Back pain, joint pain and headaches affect over 30% of the population. Chronic orofacial pain is a common condition and is difficult to diagnose and manage. This two-part paper aims to provide an overview of novel understanding of neuropathic pain, and furnish clinical teams with an update on the less common and less well-recognized chronic orofacial conditions. Headaches and temporomandibular disorders are the most common conditions and are covered in separate papers (6 and 10). Trigeminal neuralgia, burning mouth, and trigeminal autonomic cephalgias are also covered in separate papers (7, 8 and 9). The remaining conditions: post-traumatic neuropathy (nerve injury); and persistent idiopathic facial pain and atypical odontalgia are discussed in this and the following paper.

Clinical relevance: Neuropathic pain, though rare, is a consequence of dental treatment. Nerve injury in relation to M3M surgery, dental implants, endodontics and local anaesthesia result in 70% of affected patients experiencing chronic neuropathic pain.

Author notes: Tara Renton, BDS, MDSc, PhD, FDS RCS, FRACDS(OMS) FHEA, Professor in Oral Surgery and Nadine Kahwaja, BDS, MJDS MSurgDent, Specialist Trainee, Oral Surgery, King’s College London Dental Institute, Denmark Hill Campus, Bessemer Road, London SE5 9RS, UK.

Objective: To discuss chronic (neuropathic) orofacial pain.

ADG